Butler: Knocking on Heaven's Door


Katy Butler
Scribner, September 2013, $25
ISBN: 978-1451641974

Katy Butler

Butler reports:

I didn't find the idea for my book. It fell into my life like a ton of bricks.

My father suffered a crippling stroke at 79. My mother became his full-time caregiver, and I joined 24 million Americans helping shepherd their parents through final declines.

Next, without forethought or family discussion, doctors gave my father a pacemaker which forestalled natural death without stopping his slide into dementia and helplessness. When he no longer recognized a dinner napkin, we asked to have the pacemaker turned off. Doctors refused. His lingering death took six years, and broke my mother’s health.

I sensed that this was not just about my family, and I was right. Distress over how we die is culturally rampant. Three quarters of us want to die at home, but fewer than a quarter do. Medicare spends a quarter of its $550 billion budget on treatment in the last year of life. I wrote a "most-emailed" NYT Magazine story that zigzagged between my parents’ stories and the economic and systemic issues that blocked their ways to the “good deaths” they desired.

The piece won a 2011 Science in Society prize from NASW, and opened the door to a high-powered "tough love" New York literary agent, Amanda “Binky” Urban, who told me the first draft of my book proposal was "plodding." The fixed proposal netted a substantial preemptive offer from Whitney Frick and legendary editor Nan Graham at Scribner (Simon & Schuster). The book, a braid of memoir and investigative reporting, took two years and three drafts to complete.

I tried to keep in mind the three elements of successful articles and books: 1) a good story. 2) a trend. 3) a reflection on the eternal human condition. The narrative spine is our family story, a blended “Quest” and “Overcoming the Monster” narrative that culminates with my mother rebelling against her doctors, refusing open heart surgery, and meeting her death like a warrior, head-on. I covered the trend element by recounting the rise of lifesaving technology and the medical device industry, and how they changed how we die. Finally, trying to avoid death is an immortal human story. Think Faust.

Contact info:

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Deadline for October 2013 book blog: September 25, 2013

See submission guidelines.

Send your book description, author photo, and book cover image to Lynne Lamberg, NASW book editor, llamberg@nasw.org.

Sep. 11, 2013

Advance Copy

For this column, NASW book editor Lynne Lamberg asks NASW authors to tell how they came up with the idea for their book, developed a proposal, found an agent and publisher, funded and conducted research, and put the book together. She also asks what they wish they had known before they began working on their book, what they might do differently the next time, and what tips they can offer aspiring authors. She then edits the A part of that Q&A to produce the author reports you see here.

Publication of NASW members' reports in Advance Copy does not constitute NASW's endorsement of their books. NASW welcomes your comments and hopes this column stimulates productive discussions.

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